Individual provider Active NPI

Dyanna Klynn Dattilo

  • Speech-Language Assistant
  • Batavia, IL
National Provider Identifier
1396992749
Registry record updated Aug 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
217000212 Issued in IL
Practice address
1049 E Wilson St
Batavia, IL 60510-2474
Phone
(630) 761-0900
NPI assigned
Aug 27, 2008
Last updated
Aug 27, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 217000212 IL Primary

Addresses

Primary practice location

1049 E Wilson St
Batavia, IL 60510-2474

Mailing address

1309 Stonebridge CT
Bartlett, IL 60103-8900
Phone (630) 372-0779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
217000212ILMDSpeech-Language Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219795200000",
    "number": "1396992749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 STONEBRIDGE CT",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601038900",
            "telephone_number": "630-372-0779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 E WILSON ST",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605102474",
            "telephone_number": "630-761-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATTILO",
        "first_name": "DYANNA",
        "middle_name": "KLYNN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-27",
        "last_updated": "2008-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "IL",
            "license": "217000212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batavia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.